Background: Presently, there is increasing public consciousness regarding the contamination and detection of microplastics (MPs) within the human body, and studies on the detection and characterization of MPs in human breast milk are limited. Objectives: This study aims to investigate the prevalence and characteristics of MPs found in human breast milk and examine the relationship between maternal hygiene practices, complications that may arise during breastfeeding, and the composition of the bacterial microbiota. Methods: Postpartum breast milk was analyzed for MPs using Raman micro-spectroscopy. The relationship between MP detection, maternal hygiene, breastfeeding complications, and bacterial microbiota was examined. In order to identify correlations and differences between groups that had detected and non-detected MPs, statistical analyses were performed, which involved demographic comparisons and correlation network analysis. Results: The mean age of the 59 postpartum women was 28.13 years. We found MPs in 38.98% of breast milk samples (23 of 59), exhibiting diverse morphological and chemical characteristics. Most MP polymers were polypropylene, polyethylene, polystyrene, and polyvinyl chloride. Maternal hygiene and breastfeeding complications differed between the MPs-detected and non-detected groups. Maternal behaviors may influence the presence of microplastics in breast milk, which were associated with these differences. Bacterial microbiota analysis revealed significant taxonomic differences between the MPs-detected and non-detected groups. Staphylococcus and Streptococcus dominated the MPs-detected group, while Enterobacter, Escherichia, Pseudomonas, and Acinetobacter dominated the non-detected group. The MPs-detected group had a more even bacterial distribution, especially Bacteroides. Conclusions: This study found MPs in 38.98% of breast milk samples using Raman micro-spectrometry, with PP, PE, and PVC being the most common. Significant differences in maternal hygiene and breastfeeding complications were found between the groups with and without MPs. Breast milk microbiota may be linked to MP detection. Further study should be conducted to identify the possible maternal-child health.

Background and Objectives: Vesicovaginal fistulas (VVFs) are an abnormal communication between the vagina and bladder and the most common type of acquired genital fistulas. This review will address the prevalence, impact, and management challenges of VVFs. Materials and Methods: Epidemiologic studies examining VVFs are considered. In addition, publications addressing the treatment of VVFs are reviewed. Results: VVFs in developing countries are often caused by obstructed labor, while most VVFs in developed countries have iatrogenic causes, such as hysterectomy, radiation therapy, and infection. The reported prevalence of VVFs is approximately 1 in 1000 post-hysterectomy patients and 1 in 1000 deliveries. VVFs affect every aspect of quality of life, including physical, mental, social, and sexual aspects. Prevention of VVFs is essential. Early diagnosis is necessary to reduce morbidity. Nutrition, infection control, and malignancy detection are important considerations during evaluation and treatment. Conservative and surgical treatment options are available; however, these approaches should be customized to the individual patient. The success rate of combined conservative and surgical treatments exceeds 90%. Conclusions: VVFs are considered debilitating and devastating. However, they are preventable and treatable; key factors include the avoidance of prolonged labor, careful performance of gynecologic surgery, and early detection.

Introduction and Hypothesis: Low-energy radiofrequency (RF) thermal vaginal therapy for vaginal laxity and the genitourinary syndrome of menopause denatures collagen fibrils in the endopelvic fascia; fiber tightening during healing may stabilize the urethra and bladder neck, thereby resolving female stress urinary incontinence (SUI), especially in postmenopausal women. This study compared RF vaginal therapy with sham treatment for mild to moderate SUI. Methods: This double-blinded, randomized controlled trial, conducted at a tertiary center from September 2018 to April 2021, recruited postmenopausal women with mild to moderate degree of SUI who had never undergone surgery, energy-based therapy, or vaginal estrogen treatment. The intervention group received vaginal RF laser treatment; the sham group did not. The primary outcome was the 1-hour pad-weight test (PWT) result. Secondary outcomes were Incontinence Quality of Life (I-QOL), Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Patient Global Impression of Improvement (PGI-I), percentage of improvement among all participants, and adverse events. Data were analyzed using STATA 17.0. Results: Forty-nine participants randomized to RF (n = 23) and sham (n = 26) groups were eligible for analysis. PWT decreased during follow-up in the RF group but remained stable in the sham group; PWT did not significantly differ between groups. The 1-year post-treatment success rate was higher in the RF group (69.6%) than in the sham group (38.5%). At 1 year post-treatment, there were no statistically significant differences in any secondary outcomes. Conclusion: Low-energy RF vaginal therapy is an alternative treatment for mild to moderate SUI in postmenopausal women without serious adverse events. Larger randomized controlled trials should be conducted. Plain Language Summary: Why was the study doneLow-energy radiofrequency vaginal therapy for vaginal laxity and the genitourinary syndrome of menopause may be beneficial for postmenopausal women with stress urinary incontinence. What did the researchers do and findIn this randomised controlled study conducted at a tertiary-care hospital, This study compared RF vaginal therapy with sham treatment for postmenopausal female SUI with mild to moderate degree.One-hour pad weight test decreased during follow-up in the RF group but remained stable in the sham group.The 1-year post-treatment success rate was higher in the RF group (69.6%) than in the sham group (38.5%). What do these results meanHis study was constituted the first randomized double-blind clinical trial to examine the efficacy of vaginal RF laser therapy, compared with sham treatment, in postmenopausal women with SUI. Additionally, this study generated data that can provide insights regarding evaluate subjective and objective outcomes within 1 year after treatment.

A first-line treatment for stress urinary incontinence (SUI) is pelvic floor muscle training (PFMT) for at least three months. The key problem is that patients do not understand the importance of these exercises and their effectiveness. Mobile health apps offer new possibilities to increase treatment adherence. This study compared a reduction in SUI, exercise adherence, and quality of life in PFMT with animation vs. standard instruction. A prospective, single-blind, randomized control trial was collected. SUI patients were randomized into the application or control groups confirmed using a one-hour pad test. In the intervention group, the PFMT application was applied via mobile phone (PFMT with animations, recording system, and reminder system). The standard exercise protocol was similar in both groups. Additional follow-up was conducted at 4, 8, and 12 weeks. A total of 51 participants were randomized to the application (n = 26) and control groups (n = 25), respectively. At the 12-week follow-up, there was no significant difference between the two groups in terms of SUI cure rate, SUI severity by pad test, and daily SUI episodes from the bladder diary (p-value of 0.695, 0.472, and 0.338, respectively). The mean PFME adherence in the application group was higher than the control group at 8 weeks (66.3 ± 13.6 vs. 52.7 ± 16.6, p = 0.002) and 12 weeks (59.1 ± 13.9 vs. 37.8 ± 11.0, p = 0.001). The application group reported no difference from the conventional PFMT group in terms of improvements in SUI cure rate, symptom severity, and quality of life effects at 12-week follow-up. However, the improvement evaluated by the mean difference in SUI episodes and quality of life effects (ICIQ-UI SF) reported a better outcome in the mobile app group. The PFMT application has been proven to be an effective tool that improves PFMT adherence.

Sexual health alterations are associated with disasters. Consequently, the COVID-19 pandemic may affect female sexual function. This study aimed to determine the COVID-19 pandemic effect on female sexual function and to know the risk of female sexual dysfunction. This online, cross-sectional, observational research was conducted during the pandemic period. A logistic regression model was used to investigate the associations between outcomes and potential risk factors. In total, 432 sexually active women participating in the region affected by the COVID-19 pandemic were analyzed. The overall findings of our study are that 60 percent of females were at risk for female sexual dysfunction. The average FSFI score was 21.27 ± 7.17. Comparing female sexual behavior before and during the COVID-19 pandemic reveals a significant decrease in the frequency of having sex per week, foreplay duration, and coital duration. In the multivariate analysis, the factors associated with the development of RFSD are age greater than 45 years (adjusted odds ratios (AOR) 15.09, 95% confidence interval (CI) 3.67–62.07), body mass index (BMI) greater than 25 (AOR 3.26, 95%CI 1.23–8.67), jobs as a healthcare provider (AOR 8.45, 95%CI 3.66–19.53), previous COVID-19 infection within the previous three months (AOR 36.81, 95%CI 10.93–123.98), and screened-positive anxiety (AOR 13.07, 95%CI 4.75–35.94). COVID-19 influences female sexual behavior and may increase the risk of sexual dysfunction in women. Concern for the effects of female sexual quality of life in high-risk individuals is essential.

Background: Pelvic organ prolapse is a common condition of pelvic floor dysfunction in women, especially in adult vaginally parous and elderly women. Because of its anatomy, the anterior compartment has a significant effect on urinary symptoms. Anterior colporrhaphy and colpocleisis are major anterior compartment prolapse-related surgeries. As we know, postoperative urinary retention (POUR) is one of the most common complications following pelvic floor surgery. To prevent this complication, indwelling bladder catheterization is routinely applied. In contrast, to minimize risk of infection and the patient’s discomfort, the catheter should be removed as soon as possible. However, there is a lack of clarity regarding the optimal timing for catheter removal. Therefore, the aim of this trial is to compare the rate of POUR after anterior prolapse surgery between early transurethral catheter removal (24 h postoperatively) and our standard practice (on postoperative day 3). Methods: We conducted a randomized controlled trial among patients undergoing anterior compartment prolapse surgery between 2020 and 2021 at a university hospital. Women were randomized into two groups. After removal, if the second void residual urine volume exceeded 150 mL, POUR was diagnosed, and intermittent catheterization was performed. The primary outcome was the POUR rate. The secondary outcomes included urinary tract infection, asymptomatic bacteriuria, time to ambulation, time to spontaneous voiding, length of hospitalization, and patient satisfaction. Analysis was performed according to the intention to treat principle. The calculated sample size was 68 patients (34 patients in each group) for a 95% confidence interval, 80% power, 5% probability of type I error, and 10% data loss. Discussion: This study demonstrated that early catheter removal was comparable in POUR rate to conventional treatment with shorter hospitalization among patients undergoing anterior compartment prolapse surgery. Additionally, we observed no re-hospitalization owing to POUR. Therefore, early transurethral catheter removal is preferable following anterior compartment prolapse-related surgery.